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January 12, 1994

Pneumocystis carinii Pneumonia in Children With Perinatally Acquired HIV Infection-Reply

Author Affiliations

Centers for Disease Control and Prevention Atlanta, Ga

JAMA. 1994;271(2):103. doi:10.1001/jama.1994.03510260026016

In Reply.  —The relationship between age and survival after PCP in children remains to be clarified. Eppes and colleagues1 report a shorter survival for children younger than 6 months at diagnosis, while Connor et al2 report longer survival for children younger than 1 year. Using either a 6-month or a 12-month cutoff, we failed to detect a significant difference in survival between younger and older children. Although conflicting, these data nonetheless highlight the poor survival of children after PCP and heighten the urgency for its prevention. We strongly agree with Eppes and colleagues that children at risk for PCP should be identified as early as possible and that initiation of prophylaxis for those at risk need not wait for a definitive diagnosis of HIV infection, as such a diagnosis may not be possible until well after the onset of the period of highest risk for PCP.By suggesting

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